Disinfection Procedures and Their Effect on the Microorganism Colonization of Dental Impression Materials: A Systematic Review and Meta-Analysis of In Vitro Studies

Comparative Evaluation of Disinfection Protocols for Dental Impressions in Prosthodontics

BACKGROUND

In prosthodontics, dental impressions are essential for creating precise dental restorations. However, these impressions are susceptible to microbial contamination, which can pose a risk of infection to patients. Consequently, effective disinfection methods are crucial to prevent postoperative infections. This study aims to evaluate the effectiveness of various disinfection techniques for dental impressions used in prosthodontics.

MATERIALS AND METHODS

A total of 148 poured dental impressions were randomized into three disinfection groups: immersed in 0.5% sodium hypochlorite, 2% glutaraldehyde, or 0.2% chlorhexidine solution. The bacterial contamination was evaluated by direct colony-forming unit (CFU) counting, while the dimensional accuracy and surface detail duplication of each resin sample were determined as physical properties. Data were analyzed using SPSS version 23.0 (IBM Corp., Armonk, NY). Either analysis of variance (ANOVA) with the option for post-hoc or non-parametric tests was used to investigate and compare the efficacy of the better disinfection protocols where the p-value was considered significant if less than 0.05.

RESULTS

Glutaraldehyde showed the lowest mean CFU count (2.5 log10 CFUs), followed by sodium hypochlorite (3.2 log10 CFUs) and chlorhexidine (3.5 log10 CFUs). All disinfection protocols were able to significantly reduce microbial contamination when compared with the control group (p < 0.05). The results of the physical property assessment demonstrated acceptable dimensional accuracy in all tested protocols, with slight differences recorded between them regarding the reproduction of surface detail. More specifically, the mean dimensional deviation was in the range between 0.02 and 0.04 mm, while scores for surface detail reproduction ranged from 2 to 4. The ANOVA results revealed significant differences in microbial contamination levels (F(2, 145) = 5.72, p = 0.007) and dimensional accuracy (F(2, 145) = 3.45, p = 0.032) between the various disinfection protocols.

CONCLUSION

This study enlightens the effective sterilization protocol to be adopted in prosthodontics for dental impressions. Glutaraldehyde was most effective in microbial reduction, while sodium hypochlorite and chlorhexidine were equally effective. Therefore, clinicians must be vigilant in assessing the type of microbial flora that can be encountered during prosthodontic procedures while choosing disinfection protocols for patient safety and quality of impressions.

Evaluation of the effect of chemical disinfection and ultraviolet disinfection on the dimensional stability of polyether impression material: an in-vitro study

BACKGROUND

Various methods, chemical and physical, disinfect dental impressions. Common chemicals include 1% Sodium Hypochlorite and 2% glutaraldehyde, while UV radiation is a prevalent physical method. Few studies compare their effects on dimensional stability in polyether impressions. This study aims to assess such stability using different disinfection methods. Therefore, this study was planned to evaluate the dimensional stability of polyether impression material using different disinfection methods.

METHODS

This in vitro study compared the effects of chemical disinfectants (1% Sodium Hypochlorite and 2% glutaraldehyde) and UV irradiation on the dimensional stability of polyether impression material. Groups A, B, C, and D, each with ten samples (N = 10), were studied. Group A was untreated (control). Group B was treated with 2% glutaraldehyde for 20 min, Group C with 1% Sodium Hypochlorite for 20 min, and Group D with UV rays for 20 min. A pilot milling machine drill was used to make four parallel holes labeled A, B, C, and D in the anterior and premolar regions from right to left. After sequential drilling, four implant analogs were positioned using a surveyor for accuracy. Ten open-tray polyether impressions were made and treated as described in the groups, followed by pouring the corresponding casts. Distortion values for each disinfection method were measured using a coordinate measuring machine capable of recording on the X- and Y-axes.

RESULTS

A comprehensive analysis was conducted using the one-way ANOVA test for distinct groups labeled A, B, C, and D, revealing significant differences in the mean distances for X1, X2, X4, X5, and X6 among the groups, with p-values ranging from 0.001 to 0.000. However, no significant differences were observed in X3. Notably, mean distances for the Y variables exhibited substantial differences among the groups, emphasizing parameter variations, with p-values ranging from 0.000 to 0.033. The results compared the four groups using the one-way ANOVA test, revealing statistically significant distance differences for most X and Y variables, except for X3 and Y4. Similarly, post-hoc Tukey's tests provided specific pairwise comparisons, underlining the distinctions between group C and the others in the mean and deviation distances for various variables on both the X- and Y-axes.

CONCLUSIONS

This study found that disinfection with 1% sodium hypochlorite or UV rays for 20 min maintained dimensional stability in polyether impressions.

Comparative analysis of dimensional changes in autoclavable polyvinyl siloxane (PVS) impressions under various Sterilization/Disinfection Protocols: A randomized controlled trial

Background

Impressions that maintain their dimensional stability after autoclaving effectively control cross-infection and contamination resulting from a patient's oral secretions.

Purpose

The study aimed to assess the dimensional stability of autoclavable polyvinyl siloxanes after disinfection and sterilization.

Methods

A stainless steel metal model containing three full veneer crown preparations was fabricated according to ANSI/ADA specification No. 19. Reference grooves were established on the occlusal and axial surfaces of the abutments for accurate measurements. Forty impressions were created from the master model using single-step impression technique monophase polyvinyl siloxane material (AFFINIS, Coltene/Whaledent, Altstatten, Switzerland). The impressions were categorized into four groups: Group A (control, ten untreated impressions), Group B (ten disinfected impressions with 5.25 % sodium hypochlorite [NaOCl]), Group C (ten disinfected impressions with 2 % glutaraldehyde), and Group D (ten autoclaved impressions at 134 °C for 18 min). Subsequently, stone casts were produced using type IV gypsum products (Gelstone R, BK Giulini Chemie, Ludwigshafen/Rh., Germany). The dimensional accuracy of the obtained casts was assessed by measuring the inter-abutment measurements (between the abutments) and the intra-abutment measurements (diameter and height of the abutments). These measurements were performed using a universal measuring microscope (Olympus stereomicroscope B061 Imaging Corp. Tokyo, Japan) with a precision of 0.001 mm. The dimensions of the stone casts from the study groups were then compared to those of the control group. Data analysis was performed using a one-way ANOVA with a significance level of α = 0.05.

Results

AFFINIS impressions subjected to chemical disinfection in 5.25 % NaOCl and 2 % glutaraldehyde with different immersion times showed slight expansion in the intra- and inter-abutment measurements. The impressions autoclaved at 134 °C for 18 min showed slight shrinkage in the intra- and inter-abutment measurements. The dimensional change was statistically non-significant, and the percent of dimensional changes within the experimental groups was within the clinically accepted limit (α < 0.5).

Conclusion

AFFINIS polyvinyl siloxanes retain dimensional stability suitable for clinical use when subjected to chemical disinfection and steam autoclaving.

Evaluation of the Effectiveness of Disinfectants on Impression Materials

Background The disinfection of dental impression materials is a cornerstone of infection control in dental practice. This study aimed to evaluate the effectiveness of two disinfectants, sodium hypochlorite and iodophor, on alginate and silicone impression materials, which are prone to microbial contamination. Methods The study was structured into two main groups based on the impression material: Group I (alginate) and Group II (addition silicone), each further subdivided into two subgroups for disinfection with sodium hypochlorite and iodophor. For each subgroup, initial microbial swabs were taken before any treatment, followed by a second swab after rinsing and a final swab after disinfection. The mean colony-forming unit (CFU) counts, standard deviations, and standard errors of the mean were calculated for each stage of treatment. Results Prior to disinfection, Group I had a mean CFU count of 2,529.40, while Group II had a lower mean CFU of 1,417.40. After rinsing, there was a significant decrease in CFUs in both groups, with Group I at 1,337.10 and Group II at 415.10. Post-disinfection, Group I showed a mean CFU count of 73.00 for sodium hypochlorite and 0.00 for iodophor. Similarly, Group II achieved a CFU reduction of 99.00 with sodium hypochlorite and 0.00 with iodophor, demonstrating a marked reduction in microbial presence. Conclusion Iodophor was exceptionally effective in disinfecting both alginate and silicone impression materials, eliminating all detectable CFUs. Sodium hypochlorite also significantly reduced microbial counts but was not as effective as iodophor. Rinsing prior to disinfection was instrumental in reducing the microbial load, underscoring its importance in the disinfection protocol.

Efficacy of an impression disinfectant solution after repeated use: An in vitro study

Statement of problem

There are very few studies using Benzalkonium Chloride (BAC) as an active disinfection agent for immersion techniques and there are no studies investigating the efficacy of repeated use of a disinfectant solution.

Purpose

This study evaluated an impression disinfectant by testing bacterial contamination of disinfectant batches used in a clinical setting after repeated use.

Materials and methods

Liquid samples were collected from impression disinfectant solutions used to disinfect dental impressions taken at a university dental clinic. The experimental samples (500 ml from 1 L of solution) were collected from teaching and professional clinics and the in-house commercial processing laboratory and stored at room temperature each day of clinic operation over five weeks. To determine to what extent the disinfectant efficacy of the active product decreased over time, the following tests were carried out: a. Inoculation b. Gram staining technique c. Matrix Assisted Laser Desorption/Ionization Mass spectrometry (MALDI- MS). Microbial growth was monitored and photographed. A culture revival was made from colonies grown on sheep blood agar, to isolate pure colonies incubated for 24 h at 37 °C. Each morphologically distinct type of colony was gram stained and MALDI spectrometry analysis was performed using the VITEK MS (BioMerieux Inc.).

Results

Evidence of growth of bacteria was detected in teaching clinics' samples, and no growth from the professional clinic or the commercial laboratory.

Conclusions

The study demonstrated that impression disinfectanat solution tested is effective against common oral bacteria, despite some rare species such as Bacillus circulans, Bacillus horneckiae, Bacillus altitudinis/pumilus and Bacillus cereus showing evidence of survival in solutions used for disinfection of impressions. However, in a high use teaching clinic environment its efficacy deteriorated. Though a second level disinfection protocol in the commercial laboratory-maintained impression disinfection.

Antimicrobial Efficiency of Hypochlorous Acid and Its Effect on Some Properties of Alginate Impression Material

Dental clinicians and professionals need an affordable, nontoxic, and effective disinfectant against infectious microorganisms when dealing with the contaminated dental impressions. This study evaluated the efficiency of hypochlorous acid (HOCl) as an antimicrobial disinfectant by spraying technique for the alginate impression materials, compared with sodium hypochlorite, and its effect on dimensional stability and reproduction of details. HOCl with a concentration of 200 ppm for 5 and 10 min was compared with the control group (no treatment) as a negative control and with sodium hypochlorite (% 0.5) as a positive control. Candida albicans, Staphylococcus aureus, and Pseudomonas aeruginosa were selected to assess the antimicrobial activity with the colony forming unit test in addition to the dimensional stability and reproduction of details tests. The results revealed that HOCl had significant antimicrobial activity against all tested microorganisms and experimental time. Interestingly, HOCl showed no impact on the dimensional stability of alginate impression material. HOCl could be an effective antimicrobial agent for alginate impression material without interfering with their surface details and dimensional stability.

Effect of chemical disinfection on the dimensional stability of polyvinyl ether siloxane impression material: a systemic review and meta-analysis

BACKGROUND AND OBJECTIVES

Polyvinyl ether siloxane (PVES) possesses ideal characteristics for making precise and accurate dental impressions. PVES dimensional stability owes to its better polymeric properties derived from its parent materials poly ethers and polyvinyl siloxanes. As recommended use of chemical disinfecting agents is getting more popular, there is a growing concern associated with the effect of disinfectants on PVES dimensional stability. This study was aimed to understand the PVES behavior when subjected to chemical disinfectants.

MATERIALS AND METHODOLOGY

The data was collected from research studies retrieved from Google Scholar, Scopus, and PubMed using MeSH terms of keywords "vinyl polyether siloxane AND Disinfection" or (Vinyl polyether siloxane OR polyvinyl siloxane ether OR PVES) AND (disinfectant OR disinfection)" without any restriction to publication date. The PRISMA (Preferred Reporting Items for Systemic Review and Meta-Analysis) directions were observed during the data collection, screening of studies, and meta-analysis. The primary data were retrieved, and batch exported from databases using Harzing's Publish or Perish software; primary analysis was performed in Microsoft Excel, while statistical analysis for effect size, two-tailed p-values, and heterogeneity among studies was performed using Meta Essentials. The effect size was calculated using Hedge's g values at the 95% confidence level using the random-effects model. Heterogeneity among studies was measured using the Cochrane Q and I².

RESULTS AND CONCLUSION

Dental impressions made from the PVES elastomeric impression materials showed no significant changes in dimensional stability. Immersion in the chemical disinfectant for 10 min was associated with clinically irrelevant changes in the dimensions of the PVES impressions. Disinfection with sodium hypochlorite was associated with clinically significant changes in dimensions, with a two-tailed p-value of 0.049. Disinfection with 2-2.5% glutaraldehyde solution was not associated with any significant dimensional variability.

Special Issue "Recent Advances in Biomaterials and Dental Disease" Part I

Oral cavities provide an entry point for food and nutrients [...].

Disinfection of polyvinyl siloxane impression material using ozone gas, 0.1% riboflavin, glutaraldehyde, and microwave irradiation and their effect on physical properties

AIM

To assess the antimicrobial effect of ozone gas (OG) 0.1% riboflavin (RF), glutaraldehyde (GaH), and microwave irradiation (MI) on Polyvinyl siloxane impression material formerly colonized with E. coli, P. Aeruginosa, E. faecalis, and S.aureus and their effect on the physical properties MATERIAL AND METHODS: One hundred disk-shaped specimens (diameter 10 mm and thickness 3 mm) were developed by using polyvinylsiloxane impression material and inoculated by the American Type Culture Collection (ATCC) of E. coli, P. aeruginosa, E. faecalis, and S.aureus in an in-vitro setup. The samples were arbitrarily isolated into five groups and subjected for 3 min to the designated disinfection modality. Group 1 Control, group 2: GaH, group 3: 0.1% RF, group 4: MI, and group 5 OG. Following decontamination, the physical properties (contact angle, strain-in-compression, and tear strength) of impression materials were evaluated. Statistical analysis for CFU/mL (log10) for exposed E. coli, P. aeruginosa, E. faecalis, and S.aureus was performed by using analysis of variance (ANOVA) and Tukey's multiple comparison tests at a p-value of less than 0.05.

RESULTS

The most effective antimicrobial efficacy for impression disinfection against all scrutinized microbial colonies were displayed by group 5 OG and the lowest disinfection effectiveness was unveiled by the control group with no treatment. The intragroup comparison revealed that impression disinfection with GaH, MI, and ozone corroborated analogous antimicrobial efficacy(p > 0.05). The disinfecting capacity of the impression material with 0.1% RF was significantly less than MI, GaH, and OG (p < 0.05).

CONCLUSION

Disinfection of polyvinyl siloxane impression material with ozone gas, microwave irradiation, and glutaraldehyde demonstrated reasonable antimicrobial efficiencies against E. coli, P. aeruginosa, E. faecalis, and S.aureus with no detrimental effects on the physical properties of impression material. More studies are advocated to extrapolate the findings of the present study.

Infection Control in Dental Clinics: Prosthodontics Perspectives

AIM

The aim of this article is to discuss the infection control measures with focus on those related to prosthodontic work.

BACKGROUND

The risk of transmission of several infectious microorganisms during dental procedures and the increased awareness and knowledge of infectious diseases have led to an increased attention to the importance of infection control. Prosthodontists and dental personnel are exposed directly or indirectly to a significant risk of acquiring healthcare-associated infections.

REVIEW RESULTS

High standards of occupational safety and dental infection control must be applied by dental personnel for the safety of patients and dental healthcare workers. All reusable items (critical and semicritical instruments) that come in contact with the patient's saliva, blood, or mucous membranes must be heat-sterilized. Proper disinfectants should be used to disinfect nonsterilizable instruments (e.g., wax knifes, dental shade plastic mixing spatula, guides, fox bite plane, articulators, and facebows).

CONCLUSION

In prosthodontics, items potentially contaminated with patient's blood and saliva are transported between dental clinics and dental laboratories. Such fluids may contain microorganisms with high potential for transmission of several diseases. Therefore, sterilization and disinfection of all items used during prosthodontic work should be part of infection control protocol in dental care setting.

CLINICAL SIGNIFICANCE

In prosthodontic practice, a strict infection prevention plan should be implemented to minimalize the risk of infectious diseases transmission among prosthodontists, dental office, dental laboratory personnel, and patients.

Alginate-Based Bio-Composites and Their Potential Applications

Over the last two decades, bio-polymer fibers have attracted attention for their uses in gene therapy, tissue engineering, wound-healing, and controlled drug delivery. The most commonly used bio-polymers are bio-sourced synthetic polymers such as poly (glycolic acid), poly (lactic acid), poly (e-caprolactone), copolymers of polyglycolide and poly (3-hydroxybutyrate), and natural polymers such as chitosan, soy protein, and alginate. Among all of the bio-polymer fibers, alginate is endowed with its ease of sol–gel transformation, remarkable ion exchange properties, and acid stability. Blending alginate fibers with a wide range of other materials has certainly opened many new opportunities for applications. This paper presents an overview on the modification of alginate fibers with nano-particles, adhesive peptides, and natural or synthetic polymers, in order to enhance their properties. The application of alginate fibers in several areas such as cosmetics, sensors, drug delivery, tissue engineering, and water treatment are investigated. The first section is a brief theoretical background regarding the definition, the source, and the structure of alginate. The second part deals with the physico-chemical, structural, and biological properties of alginate bio-polymers. The third part presents the spinning techniques and the effects of the process and solution parameters on the thermo-mechanical and physico-chemical properties of alginate fibers. Then, the fourth part presents the additives used as fillers in order to improve the properties of alginate fibers. Finally, the last section covers the practical applications of alginate composite fibers.